Renal: Epididymitis: Free MSRA Podcast

⚕️ FREE MSRA PODCAST – Epididymitis & Epididymo-orchitis🎧 A clear, high-yield breakdown of this common cause of scrotal pain and swelling – perfect for exam prep and real-life clinical decision-making.🧠 Key Learning Points📌 Definition• Epididymitis is inflammation/infection of the epididymis.• Epididymo-orchitis involves both the epididymis and testis.• May be acute (infectious) or chronic (>6 weeks).📌 Causes & Risk Factors• <35 years: STIs – Chlamydia, Gonorrhoea, Ureaplasma• >35 years: UTIs – E. coli, enteric organisms• Rare causes: TB, Behçet’s, mumps, amiodarone• Risk factors:Unprotected sexMultiple partnersUrinary tract obstructionCathetersAnal intercourseRecent urological surgeryValsalva/reflux events (e.g. straining)📌 Pathophysiology• Ascending infection from urethra or bladder• Bacterial colonisation → local inflammation → swelling, pain• Can spread from epididymis to testis → epididymo-orchitis📌 Symptoms• Gradual onset unilateral scrotal pain + swelling• Tenderness, erythema, warmth• Dysuria, urethral discharge (especially in STIs)• Fever, systemic symptoms in severe cases🧠 Mnemonic: SEED – Swelling, Erythema, Epididymis tender, Discharge📌 Differential Diagnosis• Testicular torsion – sudden severe pain, absent cremasteric reflex• Testicular tumour – usually painless lump• Hydrocele – painless swelling• Varicocele – “bag of worms” sensation• Appendage torsion – localised tenderness📌 Diagnosis• Urinalysis & culture – especially in >35s and children• NAATs (PCR) for chlamydia/gonorrhoea in younger patients• Urethral swab if discharge present• Ultrasound with colour Doppler – to assess blood flow, exclude torsion• Consider STI screen, HIV test, and imaging for structural anomalies🧠 Tip: If STI suspected → swabs + NAATs. If UTI suspected → urine culture.📌 Management• Empirical antibiotics based on likely cause:<35 years or STI risk: Ceftriaxone + Doxycycline>35 years or enteric cause: Quinolone (e.g. ciprofloxacin)• Supportive:Analgesia (NSAIDs)Scrotal elevationBed restIV fluids if unwell• Public health:Partner notification and treatment for STIsSexual abstinence until completion of therapy• Warnings: Fluoroquinolones → tendon and nerve side effects – counsel appropriately• Specialist referral for TB, Behçet’s, or recurrent cases📌 Complications• Abscess formation• Testicular infarction• Testicular atrophy• Infertility• Chronic epididymitis or chronic scrotal pain• Reactive hydrocele• Sepsis (if urosepsis develops)📌 Prognosis• Most recover fully with appropriate antibiotics and care• Delay in treatment = ↑ risk of infertility or chronic pain• Mumps orchitis → higher infertility risk in post-pubertal males📎 More MSRA Resources for Epididymitis📝 Revision Notes: https://www.passthemsra.com/topic/epididymitis-revision-notes/🧠 Flashcards: https://www.passthemsra.com/topic/epididymitis-flashcards/💬 Accordion Q&A Notes: https://www.passthemsra.com/topic/epididymitis-accordion-qa-notes/🚀 Rapid Quiz: https://www.passthemsra.com/topic/epididymitis-rapid-quiz/🎓 Full Course: https://www.passthemsra.com/courses/renal-for-the-msra/Hashtags#MSRA #MSRARevision #MSRATextbook #MSRAQuiz #MSRAQuestionBank #MSRAFlashcards #MSRAQ&ANotes #MSRAAccordions #MultiSpecialityRecruitmentAssessment #MSRAOnlineRevision #MSRARevisionWebsite #Renal #Epididymitis